Here I find myself once more, in this chaotic country I’ve grown to love, this time on the brink of monsoon rains. Although I’ve experienced nothing but blazing sun since I have arrived, the heavy humid air presses against my chest like a sheet of bricks and the skies threaten to open up, teetering on a dew point fulcrum. I hadn’t even stepped off the plane in Dhaka before I was reminded exactly where I had returned; on the tarmac were shirtless men in lungis (the sarong type garment worn by men) labouring away under floodlights into the sweaty night, possibly repairing one of the many runway potholes. The hair-raising drive into the city is always a sure way to become re-acquainted with the surroundings: weaving between colourfully painted trucks brimming with bricks, bananas, or garbage at break neck speeds, cutting through the thick black exhaust, and blaring horns the whole way, ahhh yes, music to my ears. By the time you make it to bed that first night, it feels as if you’ve run a marathon without ever having left the back seat. The mosquitoes were happy to see me again. Back home, a mosquito bites you once; around here, the persistent little buggers are perpetual plasma-sucking pests. That is, if one cunningly ends up in your mosquito net, like it did on my first night back, you had better find it and destroy it or you’ll wake up looking like you’ve contracted measles. I was recently informed mosquitoes prefer type B blood; most likely just another myth. Still, I do wonder why I seem to be targeted more than others. Calls to prayer at the break of dawn ushered me into my first morning back. The imam’s delivery can be hit or miss, but this morning, his mellifluous tones were especially beautiful. A week gone by now, I sleep right through the morning prayers, a sure sign I am well on my way to reintegration.

What am I doing here again, you ask. Well, last time I was here, September to December, 2008, I was conducting field work for my thesis study on “Prevalence of asbestosis in migrant shipbreakers from Northern Bangladesh”. While I am still working on my thesis, I have returned to Bangladesh to initiate another project; this time following up on some groundwork laid by Dr. Hugh Davies, on his last visit to Bangladesh in December. This project has to do with initiating a system of surveillance for occupational injuries.

In Bangladesh, occupationally-related morbidity and mortality are under-reported. Presently, injury information is not available in any organized form and there is no systematic collection of information on where occupational injuries are occurring, and what they are. The majority of the 65 million workers lives in rural areas in the agriculture sector with no formal industrial units; even if a system was in place to collect information, it would overlook a large portion of the population who fall outside the scope of national statistics systems.

I will be working with an organization known as the International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B) and their Health and Demographic Surveillance System. Today, ICDDR,B is an international health research institution that has evolved from being the “cholera hospital” back in 1960, to addressing a wide range of global health priorities and attracting researchers from all over the world. It is divided into five divisions, one of them being the Health Systems and Infectious Diseases Division. This division carries out community based research including two rural field stations: Mirsarai and Abhoynagar, and an urban station in Dhaka: Kamalapur. Part of their research involves the administration of the Health and Demographic Surveillance System survey to determine effectiveness of interventions such as vaccine trials.

It is by using this survey, we have proposed to incorporate a module of questions regarding occupational injuries. The questions are based from an International Labour Organization methods manual, “Occupational Injuries Statistics from Household and Establishment Surveys”, which were developed for use in countries where the traditional notification systems have restricted coverage in terms of workers, activities or types of injuries. The advantage of using a household survey is that it provides the possibility of obtaining information about people who would not normally be captured by a national statistical system. Questions and methodology have been pilot tested in Jamaica, Nigeria, and the Philippines, and will be modified to be appropriate for the Bangladeshi public.

I must say I am very pleased to be working with ICDDR,B. Of all my visits to Bangladesh, and all the organizations I have been involved with, they are one of the most professional and organized institutions, and it is clear why they are recognized the world over. Nevertheless, no matter how world class an organization is, it still suffers from some of the same problems as everywhere else: milk and sugar in my black coffee, irritating phone ring tones, overly freezing cold air conditioners, and power cuts at least six times a day, most likely due to the air conditioners! Ah well, it’s all part of the charm.